Nasopharyngeal non hodgkin lymphoma with intracranial extension

Non-Hodgkin’s lymphoma (NHL) is the second most common neoplasm found in the head and neck region after squamous cell carcinoma. Within this region, primary NHL of the nasopharynx is rare. We reported a 65-years-old woman patient with progressive worsening of chronic sinusitis with nasal obstruction, mucopurulent rhinorrhea, headache and neuralgia of the right hemiface. On physical examination, a bulky mass was observed in the nasopharynx. Neck computed tomography revealed a diffuse soft tissue mass with mild peripheral enhancement involving both nasopharyngeal walls. The cervical-facial MRI showed a bulky expansive lesion occupying the entire nasopharyngeal lumen, involving the both nasal hemifossa, ethmoidal cells, sphenoidal sinus, cavernous sinus, and pterygopalatine fossa, with intracranial extension. Biopsy revealed a diffuse large B cell lymphoma. Based on the data, chemotherapy with regiment CHOP (cyclophosphamide, hydroxydaunorubicin, oncovin/vincristine, and prednisone) was given. A good therapeutic outcome is dependent on early diagnosis and a multidisciplinary approach.